| NPI | 1619262466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 11936443-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 28680) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-10-25 |